Nutrition disorders

Food insecurity or low-access to good quality, affordable foods affects
minority women and children disproportionately (Herndon, 2014; Ivers & Cullen,
2011; Lee, 2012; Wigg Dammann & Smith, 2009). Linked to the rise in nutritionrelated
and other health problems afflicting these populations (e.g., malnutrition,
obesity, diabetes and high blood pressure among others) (Azarbad & Gonder-
Frederick, 2010; Bove & Olson, 2006; Larson, Story, & Nelson, 2009), this issue
has been gaining some attention. Still, programs combating weight and “weightrelated
disorders” generally focus on individualistic solutions (Orbach, Bodies
2009)—such as increasing daily exercise and vilifying certain diets.
Dismissing important spatial and systematic aspects, these approaches
rather perpetuate problematic socio-political, economic, medical, and ideological
biases informing our understanding of poverty, health and food. This project
offers and alternative perspective. Most importantly, it 1) scrutinizes sexist,
classist and racist constructs across the literature on overweight, obesity, poverty,
and health; 2) examines the relationship between our food system, the growth in
nutrition-related diseases, and the intersections of gender, race, and class within
food insecure communities; and 3) analyzes interview data looking for important and resonating themes that could guide the development of more efficient local
food access strategies. As this study shows, these women’s experiences,
knowledge, and strategies have the potential of, not only helping eradicate food
insecurity across South Florida, but also combating a great number of the
nutrition-related health problems afflicting these populations.

Registered dietitians, while knowledgeable in food and nutrition, are also intrinsically educators, a role that is now receiving in-depth exploration. As nutrition educators or counselors, dietitians have been stereotyped as food cops (Licavoli, 1995, p. 751); that is, individuals who provide the dos and don'ts list. Research in the area of nutrition education may foster movement away from this stereotype. The purpose of this study was to compare the effectiveness of traditional nutrition counseling with stage-matched nutrition counseling by registered dietitians using clients in acute care settings while measuring behavioral and cognitive change outcomes. An experimental design using randomly assigned subjects to a control and two experimental groups was utilized. A pretest-posttest design was employed with a 3 month interval between the pretest and posttest. The treatment variables consisted of stage-matched intervention with feedback and stage-matched intervention without feedback. Subjects were recruited from the patient population of dietitians employed in the fourth largest public health care system in the United States based in Broward County, Florida. Two training sessions lasting 2 hours each focused on stage-matched intervention, and the research protocol was provided to prepare dietitians to work with the experimental groups. The small sample size limited the ability to generalize the findings, and interpretation of the study results was done within the context of this limitation. This study indicated the following trends: (a) subjects exposed to the NRCQ and the FRAMES model of intervention improved significantly from preintervention to postintervention compared with subjects not exposed; (b) prior to intervention, the majority of subjects were classified in Preaction Stages and postintervention classified in the Action Stage; (c) stage-matched changes were correlated with body mass index; and (d) there was no difference indicated in nutrient intake between subjects in the control and the experimental groups. Findings at this level were encouraging and consistent with the concepts of the transtheoretical model of change (TTM) and the FRAMES model. The TTM continues to be a growing area in the field of nutrition, and dietitians should receive early educational exposure so that it becomes an accepted part of the practice domain.